Health Services seeks $42M to stabilize jail health amid hiring and pharmaceutical costs; ODR and harm‑reduction asks highlight community strategy
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Summary
DHS requested $42 million of ongoing county funding to address a structural deficit in Correctional Health Services and outlined additional program asks for ODR, cancer navigation and harm‑reduction expansion, while warning that federal waiver and Medicaid funding risks could force program cuts.
Los Angeles County Department of Health Services Director Christina Ghaly appeared before the board to present DHS budget priorities for FY 2025–26 and to flag major financial risks if federal Medicaid policy or waiver funding (including the global payment program and CalAIM components) were curtailed. DHS emphasized that its hospitals, clinics, correctional health services (CHS), Housing for Health, Office of Diversion and Reentry (ODR) and harm‑reduction programs form a countywide safety‑net system that depends heavily on state and federal funding and special waiver payments.
Correctional Health Services: structural shortfall Ghaly said CHS operates with a structural deficit driven by multiple factors, and she requested $42,000,000 in ongoing county funding to right‑size the CHS budget. Key drivers cited included increased hiring (which reduced reliance on overtime but increased base costs), higher pharmaceutical expenditures, and continued post‑book claim liabilities and registry (agency temporary staff) costs.
Operational and program requests - CHS programmatic requests (ongoing): $17,000,000 request for expanded psychiatric services in the intake/reception center, outpatient and case‑management expansion, expanded outpatient services and enhanced pharmacy funding tied to opioid‑use disorder and hepatitis C treatment. - Office of Diversion and Reentry: DHS requested continued funding for ODR operations and expansion; a $16 million ongoing request was listed as offset by revenue (state felony IST and other sources) to support staffing and program delivery, with continued emphasis on converting contracts to county positions where appropriate. - Hospitals and clinics: DHS requested additional county physician FTEs tied to insourcing portions of the USC contract at L.A. County+USC Medical Center and 33 cancer navigation positions to expand oncology care coordination across the system.
Waiver and federal funding risk Ghaly warned that DHS could lose substantial revenue if federal Medicaid waivers, global payment programs, or supplemental payment streams were curtailed. She told the board those sources are essential to cross‑subsidize public care and provide services in lower‑cost outpatient settings; she said a loss of waiver or federal payments could force service reductions or facility changes and that DHS is working with the Chief Executive Office and state partners on contingency planning.
Harm reduction and community‑based services DHS reported expansion plans for harm reduction platforms (drop‑in centers, naloxone distribution, health hubs in Skid Row and MacArthur Park) and said opioid settlement and AB109/PSRIT funds are being considered to support ongoing operations. DHS asked the CEO’s office to review opioid settlement applications and planned recommendations in March 2025.
Ending: Ghaly told the board DHS will continue to refine cost estimates and contingency plans for CHS and waiver risks and asked the board to weigh ongoing resource adjustments to avoid program disruptions to patient care and community services.